Alternative Response Criteria (Choi, European Association for the Study of the Liver, and Modified Response Evaluation Criteria in Solid Tumors [RECIST]) Versus RECIST 1.1 in Patients With Advanced Hepatocellular Carcinoma Treated With Sorafenib

  • Maxime Ronot
    Departments of Radiology, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Mohamed Bouattour
    Departments of Hepatology, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Johanna Wassermann
    Departments of Medical Oncology, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Onorina Bruno
    Departments of Radiology, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Chantal Dreyer
    Departments of Medical Oncology, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Béatrice Larroque
    Biostatistics, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Laurent Castera
    Departments of Hepatology, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Valérie Vilgrain
    Departments of Radiology, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Jacques Belghiti
    Hepatobiliary and Pancreatic Surgery, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Eric Raymond
    Departments of Medical Oncology, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France
  • Sandrine Faivre
    Departments of Medical Oncology, Beaujon University Hospital, Assistance Publique Hopitaux de Paris, Clichy, France

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<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Introduction.</jats:title> <jats:p>Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1), may underestimate activity and does not predict survival in patients with hepatocellular carcinoma (HCC) treated with sorafenib. This study assessed the value of alternative radiological criteria to evaluate response in HCC patients treated with sorafenib.</jats:p> </jats:sec> <jats:sec> <jats:title>Patients and Methods.</jats:title> <jats:p>A retrospective blinded central analysis was performed of computed tomography (CT) scans from baseline and the first tumor evaluation in consecutive patients treated with sorafenib over a 2-year period in a single institution. Four different evaluation criteria were used: Choi, European Association for the Study of the Liver (EASL), modified RECIST (mRECIST), and RECIST 1.1.</jats:p> </jats:sec> <jats:sec> <jats:title>Results.</jats:title> <jats:p>Among 82 HCC patients, 64 with Barcelona Clinic Liver Cancer stage B-C were evaluable with a median follow-up of 22 months. Median duration of sorafenib treatment was 5.7 months, and median overall survival was 12.8 months. At the time of the first CT scan, performed after a median of 2.1 months, Choi, EASL, mRECIST, and RECIST 1.1 identified 51%, 28%, 28%, and 3% objective responses, respectively. Responders by all criteria showed consistent overall survival &gt;20 months. Among patients with stable disease according to RECIST 1.1, those identified as responders by Choi had significantly better overall survival than Choi nonresponders (22.4 vs. 10.6 months; hazard ratio: 0.43, 95% confidence interval: 0.15–0.86, p = .0097).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion.</jats:title> <jats:p>Choi, EASL, and mRECIST criteria appear more appropriate than RECIST 1.1 to identify responders with long survival among advanced HCC patients benefiting from sorafenib.</jats:p> </jats:sec>

Journal

  • The Oncologist

    The Oncologist 19 (4), 394-402, 2014-03-20

    Oxford University Press (OUP)

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